• Journal of Oral Medicine and Pain
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• v.37 no.4
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• pp.205-211
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• 2012

A 35 year-old female presented with the complaint of sudden occurrence of bite change and concurrent opening limitation, as well as pain in the right temporomandibular joint (TMJ) during mouth opening. From her history it was revealed that she had simple clicking of right TMJ for several years before onset of these symptoms, and that the clicking sound subsided recently after development of opening limitation. On clinical examination, anterior open bite, midline shift of the mandible to right, and premature contacts on left posterior teeth were observed. Maximum mouth opening and lateral movement to left were also restricted. On magnetic resonance images, the right TMJ showed anterior disc displacement without reduction and the posterior joint space is greatly collapsed by retrusion of the condyle. It was thought that the sudden occurrence of occlusal change would be resulted from abrupt displacement of the mandible associated with development of the anterior disc displacement without reduction. The stabilization appliance traction therapy was performed initially for first 3 months along with physical and pharmacologic therapy. However, the anterior open bite and opening limitation didn't resolve and the position of mandible still remained altered. So the stabilization appliance was changed to intermaxillary traction device. Then the mandible returned progressively to normal position and the occlusion became more stable and comfortable. After 5 months of intermaxillary traction therapy, the anterior open bite was dissolved completely and the occlusion became stabilized satisfactorily along with recovery of normal mouth opening range. On post-treatment magnetic resonance image, remodeling of condylar head was observed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.2
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• pp.161-164
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• 2002

In recent, distraction osteogenesis has been used to correct skeletal malformations and discrepancies in the craniofacial area. It also seems to be considered as an alternative in the treatment of severe midfacial hypoplasia. There are some types of distractors for midfacial distraction such as subcutaneous distractors and rigid external distractors. We used a rigid external distractor for correction (RED) of craniofacial hypoplasia. Seven patients underwent a midfacial distraction osteogenesis with a rigid external distractor between April 2000 and July 2001. Three patients suffered from Apert's syndrome, three patients from Crouzon's syndrome, and one patient suffered from midfacial hypoplasia due to midfacial radiotheraphy during childhood. On average, the mean distance of distraction was 19.8mm ($10{\sim}25mm$) and the distraction lasted for 24 days. The patients showed no severe complications like infections, optic disturbance, or wrong distraction vectors. One patient complained pain on the site of the occipital fixation of the distractor. In one patient who underwent subtotal craniectomy 3 months before Le Fort III distraction, the distractor was dislocated as the cranial bone was too weak to support the distractor. This report reveals that the application of rigid external distractor and transfacial pull results in an exact control of the distraction vectors and an excellent correction of midfacial hypoplasia without any severe complications.

• The korean journal of orthodontics
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• v.37 no.2 s.121
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• pp.98-113
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• 2007

Objective: The purpose of this study was to evaluate the displacement pattern and the stress distribution shown on a finite element model 3-D visualization of a dry human skull using CT during the retraction of upper anterior teeth. Methods: Experimental groups were differentiated into 8 groups according to corticotomy, anchorage (buccal: mini implant between the maxillary second premolar and first molar and second premolar reinforced with a mini Implant, palatal: mini implant between the maxillary first molar and second molar and mini implant on the midpalatal suture) and force application point (use of a power arm or not). Results: In cases where anterior teeth were retracted by a conventional T-loop arch wire, the anterior teeth tipped more postero-inferiorly and the posterior teeth moved slightly in a mesial direction. In cases where anterior teeth were retracted with corticotomy, the stress at the anterior bone segment was distributed widely and showed a smaller degree of tipping movement of the anterior teeth, but with a greater amount of displacement. In cases where anterior teeth were retracted from the buccal side with force applied to the mini implant placed between the maxillary second premolar and the first molar to the canine power arm, it showed that a smaller degree of tipping movement was generated than when force was applied to the second premolar reinforced with a mini implant from the canine bracket. In cases where anterior teeth were retracted from the palatal side with force applied to the mini implant on the midpalatal suture, it resulted in a greater degree of tipping movement than when force was applied to the mini implant between the maxillary first and second molars. Conclusion: The results of this study verifies the effects of corticotomies and the effects of controlling orthodontic force vectors during tooth movement.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.31-36
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• 2002

Objective : The purpose of this study was to evaluate the clinical and radiological results after treatment of old ACL(anterior cruciate ligament) avulsion fracture of tibia. Materials and Method : 11 cases who were followed up at least 2 years after treatment in chronic ACL avulsion fracture of tibia were included in this study. The average age of patients was 26(9-66) years and the mean period of follow up was 53(24-131) months. After evaluation of the lesion and treatment of associated lesion under arthroscope, open reduction and internal fixation or fragment removal was performed. Pull-out suture was performed in 8 cases, screw fixation in 2 cases. Results : The Lysholm knee score was 64.3 in average preoperatively and improved to 96.2 average at follow up. On the Lachman test, there were mild(+) instabilities in 7 cases, moderate(++) in 4 cases. On the postoperative Lachman test, there were no instabilities in 9 cases, mild(+) instabilities in only 2 cases. According to Meyers and Mckeever's evaluation protocol, 9 cases $(81.8\%)$ were excellent, 2 case $(18.2\%)$, good. On preoperative instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference in 201b was 7.8(10-4) min in average and 2.1(6-0) mm in average at follow-up. Conclusion : In chronic ACL avulsion fracture, it is thought that combination of arthroscopic evaluation of associated injury and open reduction and fixation and fragment removal can bring about satisfactory results.

• The korean journal of orthodontics
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• v.14 no.1
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• pp.15-24
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• 1984

The purpose of this study was to evaluate the effect of O.M.A on Angle's class III malocclusion. The author analysed the data obtained from pre- and post-treatment lateral cephalograms. The results obtained were as follows : 1. Forward growth of maxillary complex was accomplished. 2. The mandible showed few morphological changes in the presence of downward and backward swing. 3. It was assumed that the hooks attached to the intraoral appliance should be placed as far frontally as possibie. 4. Relations of the upper and lower jaws were improved resulting in better facial profiles.

• The Journal of the Korean dental association
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• v.54 no.3
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• pp.217-229
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• 2016

Purpose: The aim of this study was to evaluate the soft-tissue change after the maxillary protraction therapy using threedimensional (3D) facial images. Materials and Methods: This study used pretreatment (T1) and posttreatment (T2) 3D facial images from thirteen Class III malocclusion patients (6 boys and 7 girls; mean age, $8.9{\pm}2.2years$) who received maxillary protraction therapy. The facial images were taken using the optical scanner (Rexcan III 3D scanner), and T1 and T2 images were superimposed using forehead area as a reference. The soft-tissue changes after the treatment (T2-T1) were three-dimensionally calculated using 15 soft-tissue landmarks and 3 reference planes. Results: Anterior movements of the soft-tissue were observed on the pronasale, subnasale, nasal ala, soft-tissue zygoma, and upper lip area. Posterior movements were observed on the lower lip, soft-tissue B-point, and soft-tissue gnathion area. Vertically, most soft-tissue landmarks moved downward at T2. In transverse direction, bilateral landmarks, i.e. exocanthion, zygomatic point, nasal ala, and cheilion moved more laterally at T2. Conclusion: Facial soft-tissue of Class III malocclusion patients was changed three-dimensionally after maxillary protraction therapy. Especially, the facial profile was improved by forward movement of midface and downward and backward movement of lower face.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.247-256
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• 2009

The purpose of this study was to investigate the changes of the pharyngeal space when the following appliances were inserted: the mandibular advancement appliance (MAA), tongue retaining appliance (TRA), and mandibular advancement-tongue retaining appliance (MATRA). Nine male dental students exhibiting Class I occlusion, normal body mass index (BMI), and no signs and symptoms of snoring were selected for this study. The three kinds of snoring appliances (MAA, TRA and MATRA) were fabricated for each subject. The mandibular advancement of the MAA and MATRA was set at a distance of 5 mm, and the TRA and MATRA were made to hold the tongue in front of the maxillary incisors by 10 to 20 mm. Lateral cephalometric radiographs of the following four states - with no appliance, MAA, TRA, and MATRA - were taken to examine any anatomical changes resulting from the application of the appliances. All four radiographs were traced and analyzed for twenty selected variables related to the pharyngeal space, cranio-cervical posture, and position of the soft palate and hyoid bone. According to the results of this study, there were significant increases in both the upper and lower oropharyngeal spaces when the mandible and tongue were protruded simultaneously, although there was a significant increase only in upper oropharyngeal space when the mandible or tongue was advanced separately. In conclusion, it is suggested that the MATRA may result in more positive effect on the control of snoring and OSA compared to a single use of the MAA or TRA, especially for the patients whose upper airway obstruction occurs in the lower oropharynx.

• The Journal of the Korean dental association
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• v.38 no.11 s.378
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• pp.997-1007
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• 2000

Maxillary protraction is the treatment of choice for growing patients with skeletal Class 3 malocclusion due to midfacial retrusion. Its treatment goal is to achieve skeletal movement of maxilla without dentoalveolar movement. To avoid dentoalveolar movement, it is necessary to enhance anchorage of maxillary dentition or to reduce resistance of maxilla protraction. The purpose of this report is to introduce two cases applying adjunctive surgical approach as intentional ankylosis and distraction osteogenesis respectively.

• The korean journal of orthodontics
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• v.34 no.1 s.102
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• pp.33-45
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• 2004

The purpose of this experimental study was to determine appropriate magnitude of the Gable bends to produce maximum retraction of the anterior teeth. The Calorific Machine was used to illustrate the tooth movement in three dimension. The experimental teeth except the first premolar were embedded in the artificial alveolar bone part. In a series of experiments, the extraction space was closed using arch wires with bull loops into which the gable bends of $10^{\circ},\;20^{\circ},\;30^{\circ}$ degrees were incorporated. The experiments were repeated three times for each degree of the gable bend. Before and after the space closure, radiographs were taken in the sagittal and occlusal directions using occlusal films. Analysis of variance and Scheffe post hoc test were used to determine significant differences among the three groups. The following results were obtained. 1. As magnitudes of the gable bends increased, more bodily anterior tooth movement was seen and the distance of retraction also increased. 2. As magnitudes of the gable bends increase, the amount of posterior tooth protraction decreased while intrusive and buccal movement increased. 3. The arch was coordinated by distal-in rotation of the canine and mesial-in rotation of the second premolar adjacent to the extraction space.

• The korean journal of orthodontics
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• v.31 no.2 s.85
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• pp.209-223
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• 2001

At intrusion of upper anterior teeth in patient with periodontal defect, the use of three-piece base arch appliance for pure intrusion is required. To investigate the change of the center of resistance and of the distal traction force according to alveolar bone height at intrusion of upper anterior teeth using this appliance, three-dimensional finite element models of upper six anterior teeth, periodontal ligament and alveolar bone were constructed. At intrusion of upper anterior teeth by three-piece base arch appliance, the following conclusions were drawn to the locations of the center of resistance according to the number of teeth, the change of distal traction force for pure intrusion and the correlation to the change of vertical, horizontal location of the center of resistance according to alveolar bone loss. 1. When the axial inclination and alveolar bone height were normal, the anteroposterior locations of center of resistance of upper anterior teeth according to the number of teeth contained were as follows : 1) In 2 anterior teeth group, the center of located in the mesial 1/3 area of lateral incisor bracket. 2) In 4 anterior teeth group. the center of resistance was located in the distal 2/3 of the distance between the bracket of lateral incisor and canine. 3) In 6 anterior teeth group, the center of resistance was located in the central area of first premolar bracket .4) As the number of teeth contained in anterior teeth group increased, the center of resistance shifted to the distal side. 2. When the alveolar bone height was normal, the anteroposterior position of the point of application of the intrusive force was the same position or a bit forward position of the center of resistance at application of distal traction force for pure intrusion. 3. When intrusion force and the point of application of the intrusive force were fixed, the changes of distal traction force for pure intrusion according to alveolar bon loss were as follows :1) Regardless of the alveolar bone loss, the distal traction force of 2, 4 anterior teeth groups were lower than that of 6 anterior teeth group. 2) As the alveolar bone loss increased, the distal traction forces of each teeth group were increased. 4. The correlations of the vertical, horizontal locations of the center of resistance according to maxillary anterior teeth groups and the alveolar bone height were as follows : 1) In 2 anterior teeth group, the horizontal position displacement to the vortical position displacement of the center of resistance according to the alveolar bone loss was the largest. As the number of teeth increased, the horizontal position displacement to the vertical position displacement of the center of resistance according to the alveolar bone loss showed a tendency to decrease. 2) As the alveolar bone loss increased, the horizontal position displacement to the vertical position displacement of the center of resistance regardless of the number of teeth was increased.